NPIMap

Organization Active NPI

Southeastern Orthopaedic Specialists,PA

  • Orthopaedic Surgery Physician
  • Greensboro, NC
National Provider Identifier
1285687731
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SOUTHEASTERN ORTHOPAEDIC SPECIALISTS,PA
Practice address
1130 N Church St
Suite 100
Greensboro, NC 27401-1038
Phone
(336) 375-2300
Fax
(336) 375-2318
NPI assigned
May 18, 2006
Last updated
Mar 17, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHEASTERN ORTHOPAEDIC SPECIALISTS,PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Robert Alan Wainer, MDNPI 1356387047
Title
Senior Partner
Phone
(336) 375-2300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

1130 N Church St
Suite 100
Greensboro, NC 27401-1038

Mailing address

1130 N Church St
Suite 100
Greensboro, NC 27401-1038
Phone (336) 375-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040225000980 NC Part B Supplier - Clinic/Group Practice 4587568472 Receives reassigned benefits from 28 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Eden, NC; Greensboro, NC

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Southeastern Orthopaedic Specialistspa

Locations

201 E Wendover Ave
Greensboro, NC 27401
Phone (336) 275-6318

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426550400000",
    "number": "1285687731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 N CHURCH ST",
            "address_2": "SUITE 100",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011038",
            "telephone_number": "336-375-2300",
            "fax_number": "336-375-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 N CHURCH ST",
            "address_2": "SUITE 100",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011038",
            "telephone_number": "336-375-2300",
            "fax_number": "336-375-2318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN ORTHOPAEDIC SPECIALISTS,PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHEASTERN ORTHOPAEDIC SPECIALISTS,PA",
        "enumeration_date": "2006-05-18",
        "last_updated": "2015-03-17",
        "status": "A",
        "authorized_official_last_name": "WAINER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "SENIOR PARTNER",
        "authorized_official_telephone_number": "336-375-2300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.